Management of Lower Limb Lymphoedema in the United Kingdom
Tiwari A, Myint F, Hamilton G; 2006
Synopsis: Several vascular surgeons in the U.K. took a survey about the management of lower limb lymphoedema and the resources available for its treatment in the U.K. Results of the survey are presented in this article.
Abstract: OBJECTIVE: Many investigations and treatments exist for lower limb lymphoedema. We undertook a survey on the management of this condition by vascular surgeons and the resources available for its treatment in the UK.
DESIGN: A questionnaire was designed to assess the management of lymphoedema.
MATERIALS AND METHOD: A postal questionnaire was sent to all members of the The Vascular Society of Great Britain and Ireland.
RESULTS: 251/440 (57%) consultant surgeons returned a completed questionnaire comprising 45.3% teaching hospital and 54.7% district general hospital (DGH) consultants. 77.9% of the consultants saw less than 10 patients annually with lymphoedema. The commonest causes of lymphoedema were primary lymphoedema (99.3%) and malignancy (37.1%). Lipoedema, a cause of limb swelling was only seen or recognised by 46.2% of the consultants. The commonest investigations performed were a duplex scan, lymphoscintigram, full blood count and urea and electrolytes. The common methods of confirming lymphoedema were either by lymphoscintigram (54.5%) or from a diagnosis of exclusion (33.7%). Lymphoedema physiotherapy was available only to 53.8% of the consultants. Surgery was performed by 10.5% of consultants. 73.4% of the consultants believed that lymphoedema is managed inadequately and 72.9% believed that resources are insufficient in the UK for this condition.
CONCLUSION: In the UK the majority of vascular consultants see less than 10 patients annually with lymphoedema. Very few patients undergo confirmation of this diagnosis with non-invasive investigation and very few consultants perform surgery. Management of this condition is perceived by the consultants to be poor, with a lack of resources and particular shortage of lymphoedema physiotherapists. Centralisation of these services may be a way of improving this condition.
APA Citation: Tiwari, A., Myint, F., & Hamilton, G. (2006). Management of Lower Limb Lymphoedema in the United Kingdom. European Journal Of Vascular And Endovascular Surgery, 31(3), 311-315. http://dx.doi.org/10.1016/j.ejvs.2005.09.017
AMA Citation: Tiwari A, Myint F, Hamilton G. Management of Lower Limb Lymphoedema in the United Kingdom. European Journal of Vascular and Endovascular Surgery. 2006;31(3):311-315. doi:10.1016/j.ejvs.2005.09.017.